Blood oxygen saturation is the relative amount of oxygenated hemoglobin in all of the hemoglobin present in the blood stream. This hemoglobin is packaged in biconcave discs of approximately 10 micrometers diameter which commonly occur with a density of approximately five million red blood cells per cubic millimeter. When radiant energy (e.g., light) is incident upon red blood cells, the red blood cells both scatter and transmit the incident radiant energy. The differential absorption by oxygenated and non-oxygenated hemoglobin of the radiant energy reflected by and transmitted through the red blood cells furnishes the basis for the oxygen saturation measurements.
More specifically, pulse oximeters use light of two or more different centered wavelengths to obtain measures of blood oxygen saturation by measuring the absorption and/or scattering of oxyhemoglobin and reduced hemoglobin. The measured scattering data allows for the calculation of the relative concentrations of reduced hemoglobin and oxyhemoglobin, and therefore blood oxygen saturation levels, since the scattering relationships are known.
Most multi-wavelength pulse oximeters are non-implantable devices that are clipped onto a patient's finger or ear lobe. However, it is believed that it would be beneficial to chronically implant pulse oximeters so that measures of oxygen saturation and hematocrit (the density of red blood cells) can be used as feedback for pacing optimization, disease monitoring, and the like.
Some multi-wavelength implantable oximeter catheters are known, as can be appreciated from U.S. Pat. Nos. 3,847,483 and 4,114,604, each of which are incorporated herein by reference. For multi-wavelength oximeters to work properly, light from two or more light sources (e.g., from 670, 700 and 805 nm wavelength LEDs) should be combined into a single beam, to assure that the computed oxygen saturation is accurate with varying blood flow rate, pH, hematocrit and hemoglobin. In the devices of the '483 and '604 patents, fiber optic guides are used to combine the light of multiple wavelengths into the single beam. This, however, requires significant physical space. Thus, in the devices of the '482 and '604 patents, the light sources and fiber optic guides are located in a housing that is a distance from the measurement site, and optical fibers that are within a catheter are used to deliver the combined light beam to the measurement site at the distal end of the catheter.
It would be beneficial if an implantable optical combiner requiring less physical space can be provided, thereby enabling the optical combiner to be located at the measurement site.